NPI | 1275553240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 036118695) |
Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: IN 01062175A) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2013-11-22 |